Inheriting the Right Stuff

Before there were Fitbits and Teladocs there was Apollo 13 and Skylab. If you want to gain some perspective on the future of wearable health tracking, take a look back at the industry’s high flying pioneers.

by Nicholas Genes, MD, PhD

Wearable trackers of vital sign and activity levels. Data streams. Doctors on demand to deliver remote diagnoses. The future of digital medicine may look a lot like the space program’s past.

Remote biometric monitoring was a part of the first missions beyond Earth’s atmosphere – back when it was an open question whether humans could survive the stresses of a launch and re-entry, or if we could properly function in microgravity. Starting in 1961, the Mercury astronauts had hundreds of readings of blood pressure, pulse, respiration and EKGtracings collected during their brief missions. Astronauts also held regular “private medical conferences” with ground-based physicians, on a separate channel from Mission Control – a policy NASA has continued through today.

With Gemini, the missions grew longer – and the medical monitoring increased. Sleep, balance and nutrition tracking began, and the first medical experiments were conducted on astronauts.

In the Apollo missions, health tracking was facilitated by a biosensor harness that delivered near-real-time telemetry back to Mission Control. It was these harnesses that first indicated the urosepsis fever experienced by Apollo 13 astronaut Fred Haise (he downplayed the symptoms to Mission Control’s flight surgeon).

As Apollo gave way to Skylab, then the Space Shuttle, monitoring and telemedicine capabilities grew more sophisticated. The Shuttle’s Telemedicine Instrumentation Pack was a carry-on-sized computer that facilitated remote physical exam, including the capture and forwarding of eye and ear images, and heart, lung and bowel sounds.

Telemedicine capabilities developed for space travel have been turned toward Earth-based emergencies, such as earthquakes in Mexico City (1985) and more significantly, Armenia (1988) where NASA leveraged its satellite network, A/V equipment and clinical protocols to permit US clinicians to see and treat hundreds of earthquake survivors.

Still, you’d be hard-pressed to come up with many insights into the future of earthbound digital medicine based on decades of monitoring astronauts. After all, most astronauts are healthy, fit, and relatively young individuals. Even in an environment that causes motion sickness, headaches related to fluid redistribution, renal colic, and UTIs, astronauts seem to experience medical emergencies well below the rate of the general population.

Maybe the best thing the space program’s medical experience can give us is perspective. As new telemedicine services are rolled out across the country, as the data collected by consumer fitness trackers and wearable monitors continues to grow, we may take some solace. Whatever questions we still have about digital medicine’s safety, effectiveness, accuracy, or reliability pale in comparison to the challenges facing NASA engineers, and the risks faced by the astronauts. Sometimes we have to remember, pushing forward requires not just planning and study but bravery, and maybe just a bit of the right stuff.